Background: We sought to verify the efficacy and safety of transconjunctival 23-gauge pars plana vitrectomy PPV alone by our bimanual technique for the removalof dense posteriorly dislocated crystalline lens. Methods: A retrospective, noncomparative,interventional study of 31 consecutive cases of patients who underwent23-gauge PPV alone for the removal of dense posteriorly dislocated crystalline lensfollowing complicated cataract surgeries using our bimanual technique was conducted.The main outcomes measured included best-corrected visual acuity BCVA,preoperative intraocular pressure IOP, postoperative IOP and postoperative complications. Results: In all 31 cases included in this study, those dense posteriorly dislocatedcrystalline lenses were successfully removed. The enrolled patients consistedof 17 males and 14 females with a mean age of 75.84 ± 6.17 years range 59 - 90.The mean follow-up length was 7.61 ± 1.87 months with a range of 6 months to 1year. The mean preoperative BCVA was 0.22 ± 0.11 logMAR system, and the postoperativeBCVA was 0.33 ± 0.07 logMAR system after 6 months of follow-up. Themean operative time was 46.32 ± 4.80 minutes with a range of 38.00 to 57.00 minutes.All of the conjunctival incisions self-closed within the first week with no woundleakage or hemorrhage. The postoperative complications were relatively rare. Conclusions: The removal of dense posteriorly dislocated crystalline lens might be a challengefor micro-incision vitrectomy. Our bimanual technique was proved to be an effectiveand safe method for those particular dense lenses using 23-gauge alone.